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C. S. Garudadri, S. Senthil, G. Jonnadula, A. K. Mandal, U. K. Addepalli; Glaucoma in Microspherophakia. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3976.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinical features and treatment outcomes of glaucoma in Spherophakia.
The clinical features and treatment outcomes of Spherophakia were retrospectively analyzed in 161 eyes of 81 subjects seen between 1998 and 2008
There were 46 male (56.8%) and 35 female (43.2%) patients. The mean age was 16.62 ± 11.95 years (0-45). Vision less than 20/400 at presentation was seen in 16.1% The mean refractive error for 111 eyes (69%) was - 13.66 ± -5.15 (-3 to -26).Mean IOP of 76 eyes (83%) was 21.21±10.7 (range from 10-62) mm Hg. IOP could not be recorded in 27 eyes (17%). Gonioscopy was possible in 73 eyes (45%) of which 39 (53.4%) eyes had angle closure and 34 (46.6%) had open angle and gonioscopy.There were 61 eyes with glaucoma (IOP ≥ 22 mm hg/ closed angles on gonioscopy/ disc and field changes with or without high IOP). Of the 61 eyes, 55 had IOP ≥ 22 mm Hg, 6 eyes had IOP less than 22 mm hg but had glaucomatous disc and field changes. In these 61 eyes, gonioscopy showed closed angles in 28, open angles in 13, was not done in 20 eyes. Twenty six eyes (16%) were blind due to glaucoma.Of the 61 eyes with glaucoma, 12 underwent laser iridotomy, 40 needed surgical treatment. Twenty six eyes underwent Trabeculectomy (three with MMC), 2 Phaco-Trabeculectomy, 2 Trabeculectomy with Trabeculotomy, 1 Baerveldt implant, 3 TSCPC and 6 lensectomy. Five eyes needed postoperative AC reformation; 2 of them continued to have flat anterior chamber and needed lensectomy with anterior vitrectomy for reformation of anterior chamber. Following filtering surgery, raised IOP in the postoperative period was noted in 4 eyes. One eye underwent repeat trabeculectomy and IOP was controlled, one underwent TSCPC, and the other two eyes needed medications for control of IOP. Two eyes developed high IOP following lensectomy and were controlled medically. Of the 161 eyes, 2 eyes had retinal detachment.
Glaucoma in spherophakia is difficult to manage. Treatment should be directed to the causal mechanism. Because of the abnormal lens the risk of post operative complication for trabeculectomy are high.
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